Does the risk of bowel complications change in a case where there is bowel invasion in a non functioning portion of sigmoid after diversion in a gynecologic malignancy getting CRT + brachy?   

The type of bowel complications would define the risk of being symptomatic. Diversion will help with the future risk of fistula but the patient can still develop symptomatic necrosis. That being said, I would prioritize cure in this situation as persistent disease would cause more symptoms.

I agree with @Sushil Beriwal that I would prioritize cure, especially if the patient is young, has no evidence of distant metastatic disease and the patient has already had a partial colectomy and permanent colostomy. Our group has published and presented some data in the salvage setting for bo...